Streptomycin is a bactericidal antibiotic; it was the first antibiotic remedy for tuberculosis, having been first identified on October 19, 1943.

The first randomized trial of streptomycin against pulmonary tuberculosis was carried out in 1947. The drug reduced deaths from tuberculosis at first, but after three to four months of treatment, tubercle bacilli became resistant to the drug. Later, it was found that combining with streptomycin with para-aminosalicylic acid (PAS) reduced the formation of resistance. In 1952, a third drug, isoniazid, was added, and the three drug combination proved extremely effective.

Study Of Streptomycin To Be Conducted At Trudeau Laboratory, Saranac Lake

It has been announced that the research and clinical laboratory at Trudeau has been chosen as one of three laboratories in the U. S. to participate in the study of streptomycin and the instruction of personnel who are to administer the drug.

This laboratory was chosen by the tuberculosis study section of the U. S. public health service and is under the direction of William Steenken, Jr., Saranac Lake.

(Streptomycin, a recently developed drug derived from soil fungus, has the greatest promise of any known drug in the treatment of tuberculosis, yet even it cannot be considered a cure for pulmonary tuberculosis.)

STREPTOMYCIN, like the wonder drug penicillin, is an antibiotic; that is, it combats disease by attacking the germs which cause it. Streptomycin is the more valuable in that it works against germs which are not affected by penicillin.

Penicillin, for instance, will do nothing against the germs which cause tuberculosis, but streptomycin sometimes has an almost miraculous way of routing them in certain types of cases.

Recovery Occurred

Streptomycin has clearly established its value in the treatment of tularemia, a disorder which is often contracted from handling wild rabbits. In practically every case of tularemia treated with streptomycin, complete recovery has occurred.

Infections of the urinary tract, due to coli bacillus, have also responded satisfactorily to streptomycin, but not all cases are cured by it. Infections of the urinary tract, with germs known as P. ammoniae and A. aerogenes also are cured with streptomycin. The treatment should be carried out intensively for a period of from five to seven days.

The influenza bacillus is also sensitive to the action to streptomycin. Influenzal meningitis has been treated with this preparation in combination with the sulfonamide drugs and serums, and many cures have been brought about.

When streptomycin is given, it diffuses or passes throughout the body tissues. The amount in the blood reaches the highest level in about two or three hours after the injection of streptomycin is given into a muscle. It is excreted rather quickly by the kidneys. About 60 per cent to 80 per cent is excreted in the urine within 24 hours.

Streptomycin also gets into the fluid in the spinal column and in the brain, but does not reach the brain tissue in significant amounts.

Proved Its Value

It is excreted in bile and,therefore, may prove of value in certain infections in the gall-bladder and liver. Small amounts of it also are excreted in the breast milk.

It has been found that when streptomycin is taken by mouth, it gets rid of certain germs in the intestinal tract. Thus, it may have a future use in the preparation of patients for intestinal operation.

Streptomycin may be given by what is known as nebulization, that is, in the form of a mist or vapor by blowing air through an atomizer having the streptomycin solution.

CHICAGO, Ill., April 14— William Steenken, head of the Trudeau laboratory, Trudeau, N.Y., is here for the 5th Streptomycin conference of the Veterans Administration of which he is one of the chief laboratory consultants.

While in Chicago, Mr. Steenken will also attend a meeting of the Three Central Laboratories, of which the Trudeau laboratory is one, of the U. S. Public Health Service Streptomycin Research program.

At the latter meeting, there will be a discussion of the overall problems in streptomycin research as well as the laboratory control of the clinical program.

Nation's Leading Doctors Meet To Consider Claims Made For New TB Drugs

Alarmed at what may prove to be much too extravagant claims for two new drugs called "the best anti-tubercular agents yet discovered", leading medical experts of the country will meet at 11 o'clock tomorrow in the Hotel Statler, New York City, to discuss ways and means of combating what they term the untimely and premature publicity given the treatment.

Dr. James Perkins, Director of the National Tuberculosis Association, will attend. Others called hurriedly to the special meeting include:

Dr. Burns Amberson, director of Medical Service at Bellevue Hospital; Dr. John Barnwell, head of Tuberculosis Service of the Veterans' Administration; Dr. William Tucker, chairman of the Therapeutic Committee of the American Trudeau Society; William Steenken Jr., chairman of the Laboratory Committee of the American Trudeau Society; Dr. David Cooper, vice president of the American Trudeau Society, and Dr. Walsh McDermott, editor of the American Review of Tuberculosis.

Pioneer scientific work on the two new chemical drugs which hold promise of being better and far cheaper that streptomycin in the treatment of TB, has been under way for months at the Trudeau Laboratory under the direction of Mr. Steenken and his associate, Dr. Emanuel Wolinsky. In addition, clinical testing of the new drugs is being made on selected Trudeau Sanatorium patients by Dr. Gordon Meade, Medical Director.

Preliminary evidence indicates the new drugs are at least as potent against the tuberculosis germ as streptomycin and P.A.S. — the two drugs now in common use.

In preliminary work, which the Trudeau experts consider far too limited for positive conclusions, a short course of the drug has resulted in sharp gains in appetite and weight, lowering of temperature, less coughing, reduction of sputum, lowering of germ count, and increase in strength and feeling of well-being.

DR. MEADE'S REPORT

The report of Dr. Meade states: "The drug is being administered by mouth in the form of white pills smaller than an aspirin tablet.

"Toxic reactions and side effects have been few and not serious or troublesome as yet.

"The majority of the patients have shown slight to marked beneficial effects. Two patients have shown no response.

"X-rays to date have shown no change except one case of moderate improvement.

"We have no information as yet as to whether the tubercle bacilli of these patients will become resistant to the drugs — as they do with streptomycin and all other forms of tuberculosis drug therapy to date.

NO "SURE" CURE

"Further, we have no knowledge as yet as to what will happen to these patients and their disease when treatment with these drugs is discontinued.

"There is no indication so far that these drugs will eliminate the need for careful medical supervision, bed-rest, surgery and other proved methods of treatment.

"The evaluation of any new drug must be studied on the basis of thousands of cases and a considerable time must necessarily elapse before scientifically accurate evaluation of its ultimate value can be established."

Tomorrow's meeting of the TB experts in New York City will consider particularly the widely-published statements that TB patients in Sea View Hospital, Willow Brook, Staten Island, have been brought immediate "health and happiness" by the new drugs — that the men and women suffering from the disease are now laughing and playing cards in wards in which six months ago they were doing nothing but coughing away their lives. It is expected that the views of the nation's TB leaders will be made known after their meeting tomorrow.

Los Angeles (AP) — Isoniazid, hailed six months ago as a wonder drug against tuberculosis, lost some of its glamour today in reports to the National Tuberculosis Association.

Dr. Ross L. McLean, of the Veteran Administration Hospital at Baltimore, announced the abandonment of isoniazid alone as a TB, treatment in his institution but said its use would be continued in combination with other drugs.

This was done after a massive study by the VA, the Army and the Navy of nearly 2,000 cases of TB among service men and veterans.

Dr. Paul Chapman, of Herman Kiefer Hospital, Detroit, reported nearly identical results against the disease with three different drug combinations — isoniazid alone, isoniazid with the antibiotic streptomycin, and streptomycin with paraminosalicylic acid. This last combination has been widely used with good results.

Dr. Chapman's report covered a U.S. Public Health Service project in which 1,500 TB patients in 22 hospitals were used. He said X-ray pictures and other outward evidence of the results indicated isoniazid, a chemical compound, was the equal to streptomycin and paraminosalicylic acid.

He added, however, that his associates got the "clinical impression" that isoniazid alone was not as good as the older combination treatment.

Dr. McLean said isoniazid alone was discontinued at his hospital because of the appearance in patients of TB organisms resistant to the drug.